Provider Demographics
NPI:1588294474
Name:HEPBURN, ALEXANDRIA
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:
Last Name:HEPBURN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 KINGSBURY ST
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1865
Mailing Address - Country:US
Mailing Address - Phone:567-218-0185
Mailing Address - Fax:
Practice Address - Street 1:615 KINGSBURY ST
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-1865
Practice Address - Country:US
Practice Address - Phone:567-218-0185
Practice Address - Fax:419-930-6721
Is Sole Proprietor?:No
Enumeration Date:2020-01-21
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health